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Marriage and Sex

Overcoming Physical Barriers

Sex therapist Banner conducted a research study that included 65 couples who were having sexual problems because either one or both partners were diagnosed with sexual dysfunction or arousal problems. The average length of time these couples had been together was 24 years.

The study examined what it would take for these couples to resume normal sexual relations. For 65 percent of the couples, the introduction of educational sex videos was all that was needed to jump-start stagnant sex lives, Banner discovered.

Sexual dysfunction, however, is not necessarily something that is in one's head, and is a major reason sexual relationships suffer. Erectile dysfunction among men aged 65 and older is usually related to physical problems, says Dr. Michael Werner, a New York urologist, whereas most cases of erectile dysfunction for men under 65 are more psychological.

That's not to say there isn't a mental aspect to erectile dysfunction in older men. As with any medical condition, psychological issues also come into play. For men, much of their self-esteem emanates from how they feel sexually. Erectile dysfunction (ED) affects 25 percent of men either completely or moderately by age 40, McKinlay says. By age 70, that increases to one out of two men.

More important, research in the last three to five years shows that impotence or sexual dysfunction is largely a physical problem, not an emotional problem. "Nearly everything we assumed in the last 95 years was totally wrong," says McKinlay. "E.D. is a circulatory problem, it's part of vascular disease...E.D. is an early warning sign of a heart attack."

In addition to cardiovascular conditions, depression, anxiety and prostate disease can also be factors in sexual dysfunction or sexual problems. And the bad news is that medications for these conditions negatively affect sexual functioning, creating a vicious cycle and making it harder to jump-start one's sex life, and possibly affecting a couple's overall relationship.

Viagra has replaced traditionally invasive treatments for men's sexual dysfunction, and McKinlay says new medications more effective than Viagra will soon hit the market. These will be easier to take, quicker acting and will not pose a cardiovascular threat as Viagra has shown to, he says.